Though researchers have made tremendous strides in saving the lives of patients diagnosed with breast cancer, the disease still comes back after treatment in 30 percent of women. Studies have shown that as treatments target the primary cancer occurring in the breast, "seed cells" called disseminated tumor cells (DTCs), can escape from the breast and lie quietly in other parts of the body, awakening sometimes years later as particularly aggressive cancers that are especially resistant to treatment. Not knowing who is at risk of recurrence leaves patients and care providers with no choice but to watch and wait, often causing immense distress for patients. New research taking place at the Perelman School of Medicine at the University of Pennsylvania is providing clues as to how these sleeper cells operate and new trials are giving hope to at-risk patients. Researchers leading the charge and patients involved in the study are available for in-person interviews, or via email, phone or satellite.
Using animal models, Lewis A. Chodosh, MD, PhD, director of Cancer Genetics in the Abramson Family Cancer Research Institute, and researchers from the Breast Cancer Translational Center of Excellence at the Abramson Cancer Center, have begun to understand how these cells remain viable during dormancy, what they look like, and what happens that causes them to reactivate. The new SURMOUNT and CLEVER trials are using this valuable information to target the mechanisms that allow the cells to stay alive, as well as those that allow them to reactivate.
Participants in SURMOUNT are women who have been treated for breast cancer and are now in this "watchful waiting" phase. Through a bone marrow test, researchers are able to identify participants with sleeper cells. Those who test positive for the presence of DTCs can then be enrolled in the CLEVER trial, which places participants on a regimen of medications that will actively search for and destroy dormant cells before they can travel to other parts of the body.
The trials' principal investigator, Angela DeMichele, MD, MSCE, a professor of Hematology Oncology and co-leader of the Breast Cancer Research Program, says the results could transform the way we care for patients by essentially empowering them to know if they have these cells, and treatment options available that could potentially take care of them.